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Intravenous Dilution Guidelines

Isoproterenol (Isuprel ®)

The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.    PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.

Usual Diluents

D5W, NS

Standard Dilutions   [Amount of drug] [Infusion volume] [Infusion rate]

[1 mg] [250 ml] [Titrate]

[1 - 2 mg] [250-500 ml] [Titrate]

Stability / Miscellaneous

EXP: 1 DAY (RT).

(B1/B2) agonist. IV infusion: 2 to 20 mcg/ min.
Usual initial rate: 5 mcg/min.
Titrate to HR/BP.
May give IV-push (must use 1:50,000 dilution).

Calculation of drip rate:
1 mg/250 ml (ml/hr) = 15 x mcg/min. eg: 5 mcg/min = 75 ml/hr


DOSAGE AND ADMINISTRATION
ISUPREL injection 1:5000 should generally be started at the lowest recommended dose and the rate of administration gradually increased if necessary while carefully monitoring the patient. The usual route of administration is by intravenous infusion or bolus intravenous injection. In dire emergencies, the drug may be administered by intracardiac injection. If time is not of the utmost importance, initial therapy by intramuscular or subcutaneous injection is preferred.

Recommended dosage for adults with heart block, Adams-Stokes attacks, and cardiac arrest:
Route of Administration Preparation of Dilution Initial Dose Subsequent Dose Range*
Bolus intravenous injection Dilute 1 mL (0.2 mg) to 10 mL with Sodium Chloride Injection, USP, or 5% Dextrose Injection, USP 0.02 mg to 0.06 mg (1 mL to 3 mL of diluted solution) 0.01 mg to 0.2 mg (0.5 mL to 10 mL of diluted solution)
Intravenous infusion Dilute 10 mL (2 mg) in 500 mL of 5% Dextrose Injection, USP 5 mcg/min. (1.25 mL of diluted solution per minute)
Intramuscular Use Solution 1:5000 undiluted 0.2 mg (1 mL) 0.02 mg to 1 mg (0.1 mL to 5 mL)
Subcutaneous Use Solution 1:5000 undiluted 0.2 mg (1 mL) 0.15 mg to 0.2 mg (0.75 mL to 1 mL)
Intracardiac Use Solution 1:5000 undiluted 0.02 mg (0.1 mL)

*Subsequent dosage and method of administration depend on the ventricular rate and the rapidity with which the cardiac pacemaker can take over when the drug is gradually withdrawn.

There are no well-controlled studies in children to establish appropriate dosing; however, the American Heart Association recommends an initial infusion rate of 0.1 mcg/kg/min, with the usual range being 0.1 mcg/kg/min to 1 mcg/kg/min.

Recommended dosage for adults with shock and hypoperfusion states:

Route of Administration

Preparation of Dilution†

Infusion Rate††

Intravenous infusion

Dilute 5 mL (1 mg) in 500 mL of 5% Dextrose Injection, USP

0.5 mcg to 5 mcg per minute (0.25 mL to 2.5 mL of diluted solution)

†Concentrations up to 10 times greater have been used when limitation of volume is essential.

††Rates over 30 mcg per minute have been used in advanced stages of shock. The rate of infusion should be adjusted on the basis of heart rate, central venous pressure, systemic blood pressure, and urine flow. If the heart rate exceeds 110 beats per minute, it may be advisable to decrease or temporarily discontinue the infusion.

 

Recommended dosage for adults with bronchospasm occurring during anesthesia:

Route of Administration

Preparation of Dilution

Initial Dose

Subsequent Dose

Bolus

intravenous

injection

Dilute 1 mL (0.2 mg) to 10 mL with Sodium Chloride Injection, USP, or 5% Dextrose Injection, USP

0.01 mg to 0.02 mg (0.5 mL to 1 mL of diluted solution)

The initial dose may be

repeated when necessary


Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Such solution should not be used.


HOW SUPPLIED
Ampul
0.2 mg (0.2 mg/mL)
1 mL
UNI-AMP® pak of 25

Ampul
1 mg (0.2 mg/mL)
5 mL
10 ampuls per carton

Protect from light. Keep in opaque container until used.
Store at controlled room temperature 20° to 25°C (68° to 77°F). [See USP.]
Do not use if the injection is pinkish or darker than slightly yellow or contains a precipitate.


©Hospira 2004
EN-0427

HOSPIRA, INC., LAKE FOREST, IL 60045 USA
Source: [package insert]
Disclaimer
The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.  PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.
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